Milne D, James I
University of Newcastle upon Tyne, UK.
Br J Clin Psychol. 2000 Jun;39(2):111-27. doi: 10.1348/014466500163149.
A systematic review was undertaken of studies that have assessed objectively the impact of supervision and consultancy. As well as gauging effectiveness, we examined the methodological rigour of these studies.
Twenty-eight empirical studies of the change processes occurring between participants within the educational pyramid, 'consultant-->supervisor', 'supervisor-->supervisee' and 'supervisee-->patient', were analysed. The inclusion criteria also required that supervision was analysed under field conditions and there were objective measures of learning outcomes. Each study was analysed by reference to an evaluation manual, with two independent raters obtaining satisfactory reliability.
Studies meeting the above criteria came mainly from the intellectual disability specialty and included many studies using cognitive-behavioural methodologies. The studies included in this sample had more rigorous methodologies than those reviewed by Ellis, Ladany, Krengel, and Schult (1996). The findings of the review suggested that the pyramid approach benefited patients. Closely monitoring the supervisee, modelling competence, providing specific instructions, goal setting and providing contingent feedback on performance were the dominant methods of supervision and were associated with benefits to supervisees.
Despite the large body of literature on supervision, there have been relatively few empirical investigations of the educational pyramid. This work identified a number of studies with good methodological rigour, although these too often failed to provide adequate background and assessment details regarding each of the members of the pyramid, particularly the consultant. The results of cognitive-behavioural supervision were found to be positive.
对客观评估督导和咨询影响的研究进行系统综述。除了衡量有效性外，我们还考察了这些研究的方法严谨性。
分析了28项关于教育金字塔中参与者之间发生的变化过程的实证研究，这些过程包括“咨询师→督导”、“督导→受督导者”和“受督导者→患者”。纳入标准还要求在实地条件下分析督导情况，并且要有学习成果的客观衡量指标。每项研究都参照一本评估手册进行分析，两名独立评分者的信度令人满意。
符合上述标准的研究主要来自智力残疾专业，包括许多使用认知行为方法的研究。本样本中的研究比埃利斯、拉达尼、克伦格尔和舒尔特（1996年）综述的研究方法更严谨。综述结果表明，金字塔方法对患者有益。密切监测受督导者、示范能力、提供具体指导、设定目标以及对表现提供依情况而定的反馈是主要的督导方法，并且与对受督导者有益相关。
尽管有大量关于督导的文献，但对教育金字塔的实证研究相对较少。这项工作确定了一些方法严谨性良好的研究，尽管这些研究往往未能提供关于金字塔每个成员，特别是咨询师的充分背景和评估细节。认知行为督导的结果被发现是积极的。
